Health Insurance in New Hampshire

Medicaid in New Hampshire

New Hampshire expanded Medicaid in 2014 under its NH Health Protection Program. The program covers adults aged 19 to 64 with household incomes up to 138% FPL (about $20,780 for a single person in 2026). Roughly 55,000 New Hampshire residents are enrolled through expansion.

The state's expansion program has been reauthorized multiple times by the legislature. It uses managed care organizations to deliver benefits, with enrollees choosing from participating health plans. There is no coverage gap in New Hampshire, since Medicaid covers those below 138% FPL and marketplace subsidies are available above that threshold.

New Hampshire's uninsured rate is approximately 5.1%, one of the lowest in the nation. About 70,000 residents lack coverage. The state has a strong employer-sponsored insurance market, which contributes to the low uninsured rate.

What plans cost in 2026

New Hampshire marketplace premiums are moderate by New England standards. A benchmark Silver plan for a 40-year-old runs roughly $450 to $550 per month before subsidies, depending on the county. The state's two rating areas (one covering the southern tier closer to Boston, one for the rest of the state) produce some premium variation.

With enhanced subsidies expiring after 2025, many New Hampshire marketplace enrollees face significantly higher costs for 2026. The subsidy cliff returns at 400% FPL (about $62,160 for a family of two). New Hampshire had approximately 50,000 marketplace enrollees in 2025. The higher costs could push some consumers off marketplace plans, particularly those with incomes just above 400% FPL who previously benefited from the enhanced subsidies.

Carriers in New Hampshire (2026)

Two insurers offer individual marketplace plans in New Hampshire for 2026:

• Ambetter from NH Healthy Families (a Centene subsidiary) offers plans statewide. Ambetter tends to have lower premiums but uses a more limited provider network. They have been a consistent marketplace presence in New Hampshire for several years.
• Harvard Pilgrim Health Care (now part of Point32Health after merging with Tufts Health Plan) offers plans statewide. Harvard Pilgrim generally has a broader provider network than Ambetter, including most major hospital systems. Their premiums tend to be slightly higher.

With only two carriers, New Hampshire has limited but statewide competition. Every county has at least two options, which is better than many rural states where some counties have only one carrier.

Key regions

Southern New Hampshire (Nashua, Manchester, Concord)

Hillsborough and Merrimack counties are the population centers. Dartmouth Health (formerly Dartmouth-Hitchcock) has a presence here, and Elliot Hospital, Catholic Medical Center (Manchester), and Southern New Hampshire Medical Center (Nashua) are major facilities. Both marketplace carriers are available. Proximity to the Boston metro area means some residents cross into Massachusetts for specialty care, but out-of-state providers may not be in your plan's network.

Upper Valley and Lakes Region

Dartmouth Health's flagship Dartmouth-Hitchcock Medical Center in Lebanon is the academic medical center for the region and a critical resource for specialty care across northern New England. Both carriers serve this area. Premiums can be somewhat higher in rural counties due to fewer provider options.

North Country

Coos and Grafton counties in northern New Hampshire are sparsely populated with limited healthcare infrastructure. Androscoggin Valley Hospital in Berlin and Littleton Regional Healthcare are the key facilities. Access to specialists typically requires travel to Lebanon or even further south. Both carriers technically cover these counties, but in-network provider choices can be thin.

Estimate your subsidy

New Hampshire-specific things to know

No coverage gap, but affordability is still an issue. Medicaid expansion eliminated the coverage gap, but New Hampshire has a relatively high cost of living. For middle-income earners above 400% FPL who lose all subsidy help in 2026, full-price premiums of $500+ per month can be a serious burden.

Network differences matter here. With two carriers, the practical choice often comes down to whether your preferred doctors and hospitals are in-network. Ambetter's narrower network may not include some providers that Harvard Pilgrim covers, and vice versa. Always check the carrier's provider directory before enrolling.

Free enrollment help is available. New Hampshire has certified navigators and community-based enrollment assisters. NH Healthy Families and community health centers across the state offer free help with marketplace applications and Medicaid enrollment.

Resources

• HealthCare.gov for marketplace enrollment (New Hampshire uses the federal marketplace)
• NH DHHS Medicaid for Medicaid eligibility and enrollment
• NH HealthCost for price transparency and healthcare cost information